NPIMap

Organization Active NPI

Gustavus Adolphus College

  • Family Nurse Practitioner
  • Saint Peter, MN
National Provider Identifier
1508911330
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
GUSTAVUS ADOLPHUS COLLEGE
Practice address
800 W College Ave
Health Service
Saint Peter, MN 56082-1485
Phone
(507) 933-8000
Fax
(507) 933-6074
NPI assigned
Jan 24, 2007
Last updated
Jan 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Heather DaleNPI 1043300205
Title
Director of Health Service
Phone
(507) 933-7630

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X
Acute Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2100X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

800 W College Ave
Health Service
Saint Peter, MN 56082-1485

Mailing address

800 W College Ave
Health Service
Saint Peter, MN 56082-1485
Phone (507) 933-8000

Other names 1

  • Gustavus Adolphus College Health Service Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0671208Gustavus Adolphus College Health Service800 West College Ave, St Peter, MN 56082Certificate of waiverMay 31, 2028

National Provider Directory

National Provider Directory

Locations

800 W College Ave
Saint Peter, MN 56082
Phone (507) 933-6462

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1508911330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W COLLEGE AVE",
            "address_2": "HEALTH SERVICE",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560821485",
            "telephone_number": "507-933-8000",
            "fax_number": "507-933-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W COLLEGE AVE",
            "address_2": "HEALTH SERVICE",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560821485",
            "telephone_number": "507-933-8000",
            "fax_number": "507-933-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUSTAVUS ADOLPHUS COLLEGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A",
        "authorized_official_last_name": "DALE",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "DIRECTOR OF HEALTH SERVICE",
        "authorized_official_telephone_number": "507-933-7630"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gustavus Adolphus College Health Service",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Gustavus Adolphus College Health Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Peter, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.